title: Change of childbirth preference after delivery among nulliparous Chinese women and their partners.
abstract: OBJECTIVE
  The aim of the present study was to assess the effect of childbirth preference among nulliparous Chinese women and their partners on actual mode of delivery, and to assess women's change in preference from vaginal delivery to cesarean and the factors associated with this change.
  
  
  METHODS
  A cohort study was conducted from July to October 2011 in the First Hospital of Tsinghua University, Beijing. Nulliparous women at the gestational age of 36-40 weeks and their partners were included. Their childbirth preference was recorded twice: once in pregnancy and again 2 or 3 days post-partum.
  
  
  RESULTS
  Women preferring cesarean during pregnancy had a 3.9-fold higher chance of undergoing a cesarean than those preferring vaginal delivery (P = 0.004), while the partner's preference had no effect (P = 0.35). Preference for cesarean in the post-partum period increased significantly compared to that during pregnancy both among women, whose preference increased from 10.1% to 28.0%, and among their partners, whose preference increased from 7.8% to 16.7% (P < 0.001 for both). The rate of change in women's preference from vaginal delivery to cesarean was 26.0%. Women having high couple's monthly income, who were feeling depressed, whose partner preferred cesarean during pregnancy or who delivered by cesarean were more likely to experience this change due to fear of labor pain and perineal cutting and a greater perceived safety of cesarean.
  
  
  CONCLUSIONS
  Women's cesarean preference during pregnancy was associated with actual cesarean delivery. Inadequate quality of care in labor and delivery and overestimation of cesarean safety underlie post-partum women's increased preference for cesarean.
authors.affiliation: Department of Obstetrics and Gynecology, First Hospital of Tsinghua University and Tsinghua University, Beijing, China; Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Wen-Ying
authors.initials: WY
authors.lastname: Li
authors.forename: Tippawan
authors.initials: T
authors.lastname: Liabsuetrakul
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002681:China; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010298:Parity; D057240:Patient Preference / Q000208:ethnology; D049590:Postpartum Period; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012727:Sex Characteristics; D012747:Sexual Partners; D055815:Young Adult
keywords: childbirth preference; couple; maternal request; partner; primipara